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Development Studies
While the body of literature on COVID-19’s impacts on family life is rapidly expanding, most studies are based entirely on self-report data, leaving a critical gap in observational studies of parent–child interactions.
- COVID-19
- emotional availability stressors
1. Background
Transmission of the novel coronavirus disease (COVID-19) was declared to be at pandemic levels in March of 2020 by the World Health Organization [1]. In response to the rapid spread of COVID-19, governments worldwide implemented measures to decrease spread, by issuing stay-at-home orders and closing schools and childcare centers, thereby forcing some families to adjust to working and learning from home; others scrambling to work as essential workers, left to improvise their children’s childcare or schooling; and others finding themselves unemployed [2]. The overall impact on lives was more severe and systemic than other public health crises in the 20th and 21st centuries [3].
Emotional availability (EA) is a construct that measures the quality of the dyadic relationship between parent and child [4], and has been used in prior studies to evaluate parent–child relationships under stress such as the COVID-19 pandemic [5,6] and parents with high ACE scores [7]. The current study utilized EA to evaluate parent–child relationships in comparison to COVID-19-related outcomes (stress or flourishing).
2. Impacts of the COVID-19 Pandemic on Individuals’ Mental Health and Relationship Functioning
The COVID-19 pandemic has been reported to have had significant impacts on individuals, including a rise in mental health issues, such as overall stress, as well as depression and anxiety specifically [8,9,10]. In addition, a marked increase in intimate partner violence has been documented in the U.S. [11,12] as well as other parts of the world [13,14,15]. At more normative levels, using community samples and survey-based research, many parents reported feeling high levels of stress during the pandemic stemming from feeling trapped at home, being fully responsible for their children’s schooling or play while at home, and caring for family members if they became ill with COVID-19 [16,17]. A normative study group that began data collection from a parenting program prior to the pandemic self-reported significant negative changes in parental mental health, child behavior, and co-parenting quality from pre-pandemic levels [18]. Middle-income families self-reported declines in overall parenting quality substantially beyond reports from low- or high-income families [18].
3. Impacts of COVID-19 on Children and Families
While families’ experiences during the pandemic were diverse, preliminary research indicates psychological, economic, and social–emotional risks [19,20]. Research has shown that long-term caregivers, including parents, were significantly more likely to experience mental health challenges and fatigue than non-caregivers during the pandemic, with greater stress predicting neglectful and harsh parenting practices [17,21]. Additional research has linked the pandemic to maltreatment, especially in the context of high economic hardship, familial stress, or low social support [22].
4. Family Stress and Abusive or Neglectful Parenting Practices
The constant close contact of family members in quarantine situations at home can and did place children at increased risk of parental aggression and even violence [3,23]. Using survey data, parents who reported chronic levels of pandemic-related stress were found to be more likely to also report harsh parenting practices and engaged in abusive or neglectful behaviors in some cases [17]. Higher reported stress, anxiety, and depression were also associated with greater child abuse potential, also as reported by parents [3]. According to secondary data analysis, although child abuse and neglect increased during the pandemic, reporting and investigation dropped significantly below the levels of prior years, suggesting that most child abuse during the pandemic period went unreported [23]. This decrease in abuse reporting was likely due to a reduction in the number of mandated reporters of child neglect and abuse that children came into contact with during shelter-in-place orders and remote education [23,24].
According to self-report data, minoritized families were disproportionately impacted by COVID-19 stress [3]. The Center for Disease Control and Prevention reported that minoritized families faced an even greater risk of harmful outcomes during the pandemic as a result of systemic discrimination, a higher likelihood of living in crowded urban areas, and a greater likelihood of working essential jobs not subject to standard quarantine guidelines, with an elevated risk of contracting COVID-19 [25]. Simultaneously, severe economic hardship from pandemic-related parental job loss put these children at risk of deprivation of basic needs [3]. However, parental reports indicated that providing social support significantly helped children and families [3].
Gender Differences. Some studies have indicated gender differences in how parents were impacted by pandemic-related parenting challenges, with mothers continuing to bear most of the burden of childcare [8,26]. Prior research on COVID-19 and families has revealed disproportionate negative outcomes for mothers compared to fathers. During the pandemic, mothers were found to be at significant risk of developing mental health issues (internalizing problems), such as depression and anxiety, especially during pregnancy [27,28,29]. Mothers also self-reported more instances of feeling lonely and anxious, and yelling at their children, than fathers [8]. Gender differences were also found in childcare during COVID-19. According to Kerr et al. [8], 76% of mothers reported they were responsible for most of the childcare during the pandemic, in comparison to 27.8% of fathers. Relatedly, mothers who worked from home during the pandemic reported significantly higher stress than fathers who worked from home [26]. Working mothers were also more likely to reduce or eliminate their paid work hours to accommodate their children’s educational and care needs during the pandemic, while fathers did not [30]. Overall, the current survey research suggests that the pandemic may have had a significantly greater impact on mothers compared to fathers [9,18,30].
Compensatory Role of Fathers. Father involvement in childcare and household tasks appears to have played a role in preventing female partners from having to leave the workforce during the pandemic [30]. Additionally, fathers of young children who were more involved in childcare prior to the pandemic were significantly more likely to stop working during the initial months of the pandemic to continue helping with childcare [30]. Although women still carried a disproportionate responsibility for childcare, the pandemic may have increased the number of men serving as the primary childcare provider, indicating a redistribution of childcare in approximately a fifth of households, at least in the United Kingdom [31]. It is possible that such “forced” trends may have some societal impacts that will last well beyond the pandemic.
5. Children
Prior studies suggest that pandemic restrictions increased children’s psychological distress, including internalizing as well as externalizing problems, as reported by parents (mothers and fathers) [32]. Young children were reported to experience more significant negative impacts in these areas than older children or adolescents [32]. However, children and adolescents of varied ages (6–20 years) and around the world reported higher rates of depression, anxiety, and PTSD, which correlates with known difficulties during other major disasters, as described in the systematic review by Marques de Miranda et al. [33]. While not all children experienced major shifts in mental health symptomology, many reported behavioral changes, especially those whose parents were experiencing a greater number of COVID-19-pandemic-related stressors [16]. These behaviors included becoming fearful, anxious, or withdrawn, and increased instances of acting out [16]. Additionally, remote learning increased children’s screen time substantially, which has implications for overall health [19,34].
6. Emotional Availability
6.1. Defining Emotional Availability
Emotional availability (EA) is defined as occurring within a dyadic relationship between caregiver and child. It is the ability of the dyad to share in a mutually beneficial, emotionally satisfying relationship, measuring the caregiver’s “receptive presence” to the child’s signals [4,35]. This receptive presence is characterized by the emotional attunement of the caregiver and the ability to respond to the information provided by their child’s emotional reactions, whether negative (e.g., distress) or positive (e.g., excitement) [36,37]. Emde [36] and Emde and Easterbrooks [37] believed that emotions serve as a barometer for the quality of a relationship. Emotional availability also utilizes a systems view towards parent–child relationships, in that individuals mutually influence and change one another through interactions [4,38]. EA consists of six dimensions: sensitivity, structuring, nonintrusiveness, nonhostility, child responsiveness, and child involvement of the caregiver. Finally, EA theory heavily relies on Bowlby’s [39] and Ainsworth and colleagues’ [40] work on attachment theory, especially in regard to the concept of caregiver sensitivity.
Adult sensitivity, the first dimension of EA, is the level to which the caregiver perceives the child’s signals and responds to them. Optimal sensitivity scores indicate high emotional warmth and attunement to the child. The second dimension of EA is structuring, or how the adult sets boundaries and creates rules for play or exploratory behaviors, while simultaneously fostering the autonomy of the child. Third, nonintrusiveness refers to the absence of “over direction, overstimulation, interference, or overprotection” [35] (p. 3), which also serves to appropriately promote autonomy while maintaining connection. The next dimension is nonhostility, referring to the absence of any hostile behaviors on the part of the adult, ranging from open to covert hostility. The last two dimensions are focused on the child’s style instead of the caregiver’s. Child responsiveness is the child’s willingness to respond to the adult’s bids for connection, supporting a balance between attachment and exploration. Child involvement of the adult is the child’s interest in including the adult in the interaction and their ability to do so effectively. These six dimensions of EA make up the EA Scales, a framework for scoring the observed parent–child interactions to evaluate levels of emotional availability [4,35]. Thus far, EA has been used for children between the ages of 0 and 14 years. This will be the first study to extend that range to 17 years, with six child participants between the ages of 13 and 17.
6.2. Emotional Availability and COVID-19
The construct of emotional availability was utilized in one of the very few observational studies of parent–child relationships during the pandemic. In a study conducted in Israel, Shakiba and colleagues [5] used the EA Scales to assess mother–child dyads during scenarios of play and frustration, occurring before (time 1: mean infant age 3.5 months) and during the pandemic (time 2: mean infant age 12.5 months). They assessed continuity, stability, and bidirectional influences. While no significant differences in EA were found for mothers, suggestive of the normative continuity of EA over time, the children demonstrated increases in responsiveness and involvement from time 1 to time 2, which corresponds with a developmental period during which there is typically a rise in the infant’s EA [41,42]. Thus, children’s typical development of EA was not disturbed.
While a highly important study, Shakiba et al. [5] did not actually measure the COVID-19-related reactions of parents, and they also focused only on mothers. In the current study, we will measure both negative and positive experiences during COVID-19 as predictors of EA. Further, while Shakiba and colleagues [5] evaluated mother–child dyads at two time points during the pandemic, they did not include a measure to evaluate parents’ reports about their stressors or wellbeing during the pandemic. Therefore, any conclusions drawn about changes in EA during the pandemic are based on assumptions about the external context of COVID, not direct associations with measurements of feelings during the COVID-19 pandemic.
The second of very few observational studies on parent–child relationships during the pandemic also utilized emotional availability as a mechanism to improve parent–child relationships, specifically in families identified as at risk of child abuse and neglect during the COVID-19 pandemic [6]. This study found that parents and children who went through a video feedback intervention demonstrated improvements in EA compared to the control group [6]. Children in this study were between the ages of 0 and 5 and over 75% of the parents in the study were mothers. Like the study by Shakiba and colleagues [5], this study did not include a measure to evaluate parents’ levels of COVID-19-related stress specifically, so relations between EA and the pandemic are based on assumptions alone [6].
6.3. COVID-19 Stress and Positive Change
One method to measure negative pandemic experiences was developed by Grasso and colleagues (2020a) and is known as the Epidemic–Pandemic Impacts Inventory (EPII). The EPII was created to evaluate impacts to individual and family life during the COVID-19 pandemic using a person-centered approach. Initial studies have supported the use of the EPII as a tool to evaluate both positive and negative experiences across multiple domains of life [43,44]. The initial study that utilized the EPII divided participants into distinct sociodemographic classes to compare their COVID-19 experiences across groups. Notably, individuals in one of the categories evaluated by the study “Parents—high exposure/high risk,” were more likely to hold essential jobs that required them to continue in-person work, experience childcare issues, take on teaching at home, utilize harsher discipline, report increased child behavioral problems, and were more likely to demonstrate symptoms of depression and anxiety due to high levels of stress [44]. According to this study’s assessment of various risk profiles, caregivers of children and adolescents experienced increased exposure to stress and higher psychosocial risk [44].
The EPII also surveyed positive COVID-19 experiences. Initial studies reveal that those who self-reported the most positive change during the pandemic also tended to report high levels of negative experiences on the other subcategories, indicating that the two are not mutually exclusive [44].
6.4. Parental Wellbeing or Flourishing
Families reported very different experiences during the COVID-19 pandemic. For some families, the immense changes to daily life created opportunities for connection and increased wellbeing, reporting that the COVID-19 pandemic was a time of healing and restoration in the wake of reduced obligations [45]. Individuals who felt fulfilled in their relationships during the pandemic reported more connection with their families [19]. To better understand wellbeing during the pandemic, we drew upon the concept of “flourishing” (Diener, 2010), which refers to individuals’ feelings of success in mutually beneficial relationships and overall feelings of self-esteem, optimism, and purpose in life [46].
6.5. Child Age
Child age has been included as a variable of interest in several self-report studies on parent–child wellbeing during the pandemic [16,32,47]. Self-report data have shown that a younger child age significantly predicted parental stress during the COVID-19 pandemic [32]. However, another self-report study found that age moderated the effect of COVID-19 on children’s emotional, cognitive, and worry reactions, such that older children were more impacted in every area [47]. Parent survey data have indicated that child age was a significant predictor of children’s acting-out behaviors, as well as anxious and withdrawn behaviors during the pandemic, such that older children demonstrated higher rates of behavioral issues [16]. Although these studies do not point to an age that is consistently “difficult”, they suggest that child age may play an important role in understanding the relationship between parent–child interactions and wellbeing during COVID-19. Research that explores the role of child age in parent–child interactions during the pandemic is both limited and conflicting, which supports the need for further evaluation of this variable.
6.6. Adverse Childhood Experiences
As described above, parental past traumas may be a risk factor for worse child outcomes during the COVID-19 pandemic [48]. Therefore, we also wanted to ask parents about their adverse childhood experiences (ACEs). ACEs are events, such as child physical and sexual abuse, poverty, and parental substance abuse, that may alter the mental and physical health of individuals if experienced at an early age [7,49,50,51,52]. Experiencing multiple ACEs places an individual at greater risk of health and mental health problems later in life [53].
During non-pandemic times, prior research has shown that mothers who had a multitude of ACEs were more likely to report distress as well as child negative social/emotional outcomes, and that EA moderated linkages in the very-low-EA group [7]. Given we were working with a low-risk sample, we did not necessarily expect ACEs to be highly predictive of our outcomes. However, based on the prior literature on ACEs as a risk factor during times of increased stress [48], we did expect that parents’ ACE scores may be an important tool to include in our understanding of parents’ EA and COVID-19 stress.
This entry is adapted from the peer-reviewed paper 10.3390/children10061044
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